How Do I Know if I Have Hemorrhoids or a Fissure?

Hemorrhoids vs. Anal Fissure

Have you been experiencing anal discomfort? Do you have trouble sitting down? These are some of the questions that come to mind when one is confused about whether they have fissures or hemorrhoids.

If you are experimenting with different remedies to alleviate your pain, you might want to stop and read this article first. Both fissures and hemorrhoids have similar symptoms, so you shouldn’t do anything without being sure of your problem first. But, you don’t have to worry anymore because we’re here to help you figure it out!

If you still haven’t consulted a doctor, it would be best to do so. A colorectal exam is the most convenient way to get an accurate diagnosis. Hemorrhoids and fissures can be troublesome, but learning more about the differences between the two can make your journey to healing faster and easier.

So, let’s start by helping you learn the differences between hemorrhoids and fissures.


Hemorrhoids, or Piles as they are most commonly called, affect roughly 3 quarters of the U.S population by the age of 50. They are often characterized by inflammation of the veins of the rectum. This can cause pain and discomfort, and in some cases, the veins can also protrude out of the anus.

According to a study published by the University of California, Berkley, hemorrhoids usually only last a few days. The paper does advise against the use of remedies that promise to numb or anesthetize the pain since they may increase irritation with prolonged use.

Piles are often associated with chronic constipation, physical strain, or even pregnancy – which can put a strain on one's bowel movements. Based on the anatomical location of these swollen or dilated veins, hemorrhoids are broadly divided into three distinct types, which are discussed down below.

Internal Hemorrhoids

Internal hemorrhoids are located inside the rectum. These can occur as swollen lumps that might not even show symptoms. Sometimes the only apparent identifiers include itching or irritability inside the anus. The person might not even know they have hemorrhoids until their hemorrhoids start to bleed, although ruptures do repair over time. These can further be classified into four types based on severity, with each type becoming progressively more painful. The most severe internal hemorrhoids end up prolapsing and cannot be pushed back inside.

External Hemorrhoids

The external area surrounding the anus has more pain receptors, therefore, making external hemorrhoids extremely painful. Although easy to identify, what makes them worse is not only the pain but also the skin tags and infections that might accompany them!

Thrombosed Hemorrhoids

So far, we've learned that inflamed and swollen veins most commonly characterize hemorrhoids, but oftentimes, clots can form in these veins. Blood clots prevent the unhampered blood flow, causing the hemorrhoid to eventually burst. These thrombosed hemorrhoids can cause extreme pain and discomfort. But, the clots are most mostly benign, so you shouldn't worry too much!


Anal fissures, from the get-go, are extremely painful. The reason for that is the tears they cause in the sensitive mucosal lining of the anus. This also makes them easy to identify. Fissures cause immediate pain during and/or after bowel movements. They can also cause spasmodic movements of the anal sphincter, accompanied by throbbing pain; the sphincter is the muscle that controls the passing of stool when one visits the bathroom.

The primary cause for anal fissures is trauma to the anal walls that can result from many reasons but occurs most commonly during strenuous bowel movements. Inflammatory bowel diseases and infections of the rectum are also among the known causes of fissures.

Similar to hemorrhoids, the contributing factors for fissures also include strained bowel movements, constipation, and pregnancy. Some other factors also include, but are not limited to, anal intercourse, cirrhosis due to alcoholism, and the loss of muscle tone due to several reasons.

They can broadly be divided into two types based on severity and the duration of their occurrence.

Acute Fissures

Freshly developed fissures are categorized as acute fissures. They are relatively easy to deal with and can be managed with simple home remedies. If left untreated, they can develop into extremely painful chronic fissures.

Chronic Fissures

These are fissures that are left untreated for more than 8-12 weeks. Pain is most likely to worsen over time, and along with anal tears, skin tags also form on the lining of the anus, as well as some extra tissue growth which is referred to as "hypertrophied papilla.”

It is not recommended to leave fissures untreated since pus-filled boils can also form on the anal linings. These can not only add to the pain and suffering of someone but also increase the risk of getting a plethora of skin infections. Chronic fissures cannot be treated at home and require immediate medical assistance.

Ending Note

To sum up, everything that has been said so far, hemorrhoids and anal fissures are medical conditions relating to the rectal region, which can cause severe pain and discomfort. Although easily treated at home with common remedies and over-the-counter drugs like cortisone, we don’t want to promote any kind of self-medication and advise consulting a trained healthcare practitioner.

It is understandable for both of these conditions to cause embarrassment to a person, but they are extremely common. With everything we've learned so far, it would be wise to give the doctor a visit – better safe than sorry!

We hope this article was informative and helped you understand the differences between these two closely related medical conditions. If you still have any questions, do not hesitate to write to us in the comment section below!